What causes hemorrhoids to bleed?

Written by Ren Zheng Xin
Gastroenterology
Updated on September 08, 2024
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Internal hemorrhoids can easily cause rectal bleeding. The main reason is the varicosity of hemorrhoidal veins. During defecation, dry and hard stools scratch the hemorrhoidal veins causing them to rupture and bleed. Additionally, due to the long-term presence of hemorrhoids, the hemorrhoidal veins become overstretched, making the vein walls thin and fragile, and easily damaged during bowel movements. For hemorrhoid-induced rectal bleeding, treatment can be administered through medications aimed primarily at reducing bleeding symptoms and alleviating the varicosity of the hemorrhoidal veins. Sitz baths can also be used to reduce swelling around the anus. If medication provides limited relief, minimally invasive or surgical treatments may be considered.

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Written by Yu Xu Chao
Colorectal Surgery
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How to treat hemorrhoids bleeding

In clinical practice, the treatment of hemorrhoidal bleeding primarily depends on the severity of the bleeding. If a patient experiences frequent hemorrhoidal bleeding and the volume of blood loss is significant, it is recommended to adopt surgical treatments early. Prolonged bleeding can lead to severe anemia, severely impacting the patient's health. Possible surgical options include sclerotherapy, internal hemorrhoid ligation, or surgeries like PPH and TST. However, if the hemorrhoidal bleeding is infrequent and the volume of blood loss is minimal, the first step should be to improve the diet. Consuming more seasonal fresh fruits and vegetables, maintaining smooth bowel movements, not spending too long on bowel movements or straining excessively, and using hemorrhoidal suppositories or ointments for anal administration after bowel movements are recommended.

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Written by Chen Tian Jing
Colorectal Surgery
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Hemorrhoids bleeding examination what

Hemorrhoid bleeding is mainly due to the rupture of local hemorrhoid mucosa or bleeding from local small arteries caused by repetitive friction and irritation. If the mucosa bleeds, the bleeding generally manifests as minor seepage; however, if small arteries rupture, the bleeding appears as dripping or squirting. To examine hemorrhoid bleeding, an anal digital examination and an anoscopy must be conducted to determine the exact location of the bleeding and the amount of blood loss. Based on the examination results, an appropriate treatment plan can be selected. For minor bleeding, local application of hemostatic creams or oral hemostatic medications can be considered. If the bleeding is more significant, appearing as dripping or squirting arterial pulsatile bleeding, it is recommended to perform ligation to stop the bleeding.

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Written by Zhao Li Li
Obstetrics
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What should a pregnant woman do if she has bleeding hemorrhoids?

Due to the impact of hormone levels during pregnancy, pregnant women are easily prone to significantly slower gastrointestinal motility, which can lead to constipation. Frequent constipation can persistently irritate the local area around the anus, easily causing hemorrhoids. Therefore, it is essential to have a nutritious diet that is light and includes plenty of coarse fibrous vegetables and fresh fruits during pregnancy, as these can promote gastrointestinal motility and alleviate symptoms of constipation. If there is bleeding at the site of anal hemorrhoids after defecation, it is necessary to seek medical attention promptly for examination, hemostasis, anti-inflammatory treatment, and symptomatic treatment.

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Written by Zhang Lu
Obstetrics
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What are the symptoms of hemorrhoids in pregnant women?

After pregnancy, the volume of the female uterus increases, and in late pregnancy, the fetus descends into the pelvis. These factors can compress the veins in the pelvic area, obstructing blood flow around the anus, causing venous blood stagnation around the anus, and making it easy for pregnant women to develop hemorrhoids or for pre-existing hemorrhoids to worsen during pregnancy. The symptoms of hemorrhoids in pregnant women include the following aspects: first, you can feel polyp-like tissue outside the anus with your hand. Second, when hemorrhoids are severe, they can cause the prolapse of hemorrhoidal tissue or be accompanied by anal bleeding. Third, hemorrhoids can sometimes be accompanied by constipation, and hemorrhoids during pregnancy should be treated through diet, exercise, and medication.

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Written by Du Rui Xia
Obstetrics
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What should pregnant women do about hemorrhoids?

Women who develop hemorrhoids during pregnancy should stop eating spicy and stimulating foods. They should eat more vegetables and fruits that are rich in fiber to facilitate bowel movements, such as bananas, daylilies, black fungus, apples, peaches, and pears. They can also use some medications for sitz baths, twice a day after each bowel movement, once in the morning and once in the evening. Additionally, they should avoid standing or sitting for long periods and can perform anal lifting exercises or massage the anal area. Massaging can help with blood circulation and can be somewhat helpful in improving hemorrhoids.